[PREDICTORS OF MODERATE COGNITIVE DISORDERS IN PATIENTS WITH CORONARY HEART DISEASE AND TYPE 2 DIABETES MELLITUS].

AIM: To study predictors of moderate cognitive disorders (MCD) in patients with coronary heart disease (CHD) and type 2 diabetes mellitus (DM2). MATERIALS AND METHODS: The study included 54 men with CPD andDM2 (mean age 56.8 ± 4.5 years). Standard medical examination was supplemented by the assessment of cognitive status, characteristics of lipid and carbohydrate metabolism. Factors allegedly influencing MCD development included the patients' age, education level, stenosis of carotid arteries, LV ejection fraction, arterial hypertension, insulin and HbAlc levels, HOMA and QUICKI indices, lipid metabolism, concentrations of total, HDL and LDL cholesterol, fructosamine, triglycerides, severity of coronary lesions (Syntax scale), trait and state anxiety. RESULTS: Fructosamine level and HOMA index were the most important characteristics responsible for MCD in patients with CPD and DM2. CONCLUSION: The data obtained demonstrate the significance of fructosamine level and HOMA index in the development of MCD in patients with CPD and DM2.

[THE COGNITIVE STATUS OF PATIENTS WITH TYPE 2 DIABETES MELLITUS AFTER CORONARY BYPASS SURGERY].

The aim of the study was to evaluate the neuropsychological status of patients with type 2 diabetes mellitus (DM2) before and I year after coronary bypass surgery performed under conditions of artificial circulation. It included 114 patients (54 with and 60 without DM2). Prior to surgery, the patients with DM2 had positive characteristics of neurodynamics and attention. They deteriorated 1 year after coronary bypass surgery, but improved in the patients without DM2.

[Effect of Statins on Development of Early Cognitive Dysfunction After Coronary Artery Bypass Grafting].

We studied the effect of rosuvastatin on the development of early postoperative cognitive dysfunction (POCD) in patients after coronary artery bypass grafting (CABG). One hundred nine men aged 45-70 year was divided into two groups. Group 1 comprised 69 patients (mean age 56.8 ± 5.2 years) who were given 20 mg of rosuvastatin for 10-14 days before CABG and until discharge. Patients of group 2 (n=40, mean age 55.9 ± 5.3 years) did not take rosuvastatin. It was shown that patients of group 2 had better neuropsychological parameters after CABG in comparison with the patients of group 2. Patients of group 1 had lower concentrations of interleukin (IL)-1ß, IL-6, IL-8, tumor necrosis factor α, high sensitivity C reactive protein, and higher concentrations of IL-10. Group 2 patients had worse neuropsychological parameters which were associated with higher concentrations of proinflammatory cytokines. These results may indicate that preoperative therapy with rosuvastatin had decreased the severity of systemic inflammatory response and reduced the development of early POCD after CABG.

[Association of cognitive impairments with carbohydrate and lipid metabolic parameters in type 2 diabetes mellitus patients undergoing coronary bypass surgery].

UNLABELLED: AIM. To comparatively analyze neuropsychological parameters in patients with coronary artery disease (CAD) depending on the presence of type 2 diabetes mellitus (DM) and to evaluate their relationship to carbohydrate and lipid metabolic parameters. SUBJECTS AND METHODS: Fifty-two male patients with type 2 DM (mean age 58.0 ± 5.7 years) and 46 male patients without this condition (mean age 57.1 ± 6.2 years) were examined. Besides standard clinical examination, neurophysiological testing and determinations of glycated hemoglobin (HbA(1c),) and insulin concentrations, QUICKI index, and blood lipid profile were made. RESULTS: The patients with DM differed from those without DM in the lower speeds of sensorimotor reactions during neurodynamic testing and in worse attention values. In the patients with type 2 DM, the worse neuropsychological status was associated with the higher plasma concentrations of glucose, insulin, HbA(1c), total cholesterol, low-density lipoproteins, and triglycerides and with the lower levels of high-density lipoproteins. These relationships were not observed in the patients without DM. CONCLUSION: The patients with CAD concurrent with DM had a worse neurophysiological status than those without DM. Only the DM group demonstrated a relationship between cognitive impairments and carbohydrate metabolic markers. Carbohydrate and lipid metabolic disturbances may be assumed to make a negative contribution to the development of cognitive impairments in patients with CAD concurrent with type 2 DM.

[A role of carotid stenoses in the structure of early postoperative cognitive dysfunction in patients underwent coronary artery bypass grafting].

OBJECTIVE: To analyze the structure and severity of early postoperative cognitive dysfunction as well the accompanying spectral electroencephalographic (EEG) changes in patients underwent coronary artery bypass grafting (CABG) depending on the presence or absence of small and moderate internal carotid stenosis. MATERIAL AND METHODS: Fifty seven patients, aged from 45 to 70 years, were stratified into two groups: without stenosis (n=35, mean age 54.3±6.4 years) and with internal carotid stenosis (n=22, mean age of 57.5±5.8 years). For all patients planned on-pump CABG was performed. RESULTS: The frequency and severity of cognitive deficits in the postoperative period were higher in patients with internal carotid stenosis compared to patients without stenosis. Also, the patients with stenosis had more pronounced EEG signs of cortical dysfunction and brain damage after CABG compared to patients without stenosis. CONCLUSION: The presence of carotid >50% stenosis increases the severity of cognitive deficits and brain damage in patients underwent on-pump CABG.

[Neuropsychological status of patients with low and moderate carotid artery stenoses after the coronary artery bypass surgery].

The purpose of the study was a comparative evaluation of a neurological and neuropsychological status of patients with and without carotid artery stenoses less than 50% after coronary artery bypass grafting. The study involved 65 patients divided into two groups: the first group included 35 patients (mean age 56.2±5.7 years) without carotid artery stenoses, the second group included 30 patients (56.8±5.5 years) with the presence of carotid artery stenoses. Initially, all patients had comparable clinical parameters. Before surgery, the high frequency of asthenic, vestibulopathic and vestibular-atactic syndromes was observed in patients with the presence of low and moderate stenoses of carotid arteries compared to patients without stenoses. After coronary artery bypass grafting, the neurological status of patients became worse in both groups. Patients with the presence of low and moderate stenoses of carotid arteries performed worse on neuropsychological tests one month after surgery.